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BDS4 Oral Medicine > Oral Mucosal Diseases > Flashcards

Oral Mucosal Diseases Flashcards

1
Q

What are the different strata in the epithelium

A

stratum basale (deep)
stratum spinosum
stratum granulosum
stratum corneum (superficial)

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2
Q

What is atrophy

A
  • reduction in viable layers
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3
Q

What is erosion

A
  • partial thickness loss
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4
Q

What is ulceration

A

fibrin on surface
complete epithelial loss

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5
Q

How can haematinic deficiencies effect oral mucosa

A

can cause glossitis
can present with linear/patchy red lesions
burning mouth syndrome
ulceration
angular stomatitis

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6
Q

What are causes of anaemia other than nutrition

A

malabsorption
pernicious anaemia
chronic bleeding

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7
Q

What are benign mucosal conditions effecting the tongue

A

geographic tongue
black hairty tongue
fissured tongue

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8
Q

What conditions are linked to geographic tongue

A
  • family history
  • down syndrome
  • fissured tongue
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9
Q

How does geographic tongue present

A
  • irregular pink/red depapillated maplike areas
  • may be surrounded by thicker yellow border
  • increased thickness of intervening filiform papillae
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10
Q

How does black hairy tongue occur

A

filiform papillae undergo hyperplasia
become discoloured as papillae pick up pigment

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11
Q

What causes black hairy tongue

A
  • accumulation of epithelial squames
  • proliferation of bacteria
  • linked to smokers, soft diet and bad OH
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12
Q

What is the management of black hairy tongue

A
  • improve OH
  • remove elongations with tongue scraper
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13
Q

What is fissured tongue

A

aka scrotal tongue
usually asymptomatic but may become inflamed if enough food get trapped in fissure
discomfort may warrant investigations for additional disease e.g candida/LP

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14
Q

What are causes of swelling in the oral mucosa

A
  • papillary hyperplasia
  • epulides
  • fibroepithelial polyp
  • mucocele
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15
Q

What is papillary hyperplasia caused by

A
  • minor trauma e.g rocking of ill fititng denture
  • can also be associated with candida
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16
Q

How does papillary hyperplasia present

A
  • numerous tightly packed papillary projections
  • seen on denture bearing area
  • pebbled appearance
  • mucosa is red and oedematous
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17
Q

What are the histological features seen in papillary hyperplasia

A
  • papillary projections
  • hyperplastic, inflamed granulation and fibrous tissue
  • hyperplastic stratified squamous epithelium
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18
Q

What are epulides

A

localised tumour like gingival enlargement

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19
Q

How do epulides present

A
  • they are hyperplastic
  • tend to arise from interdentla tissues
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20
Q

What are the main aetiological factors for epulides

A
  • trauma/chronic irritation
    *common causes are subgingival calculus & overhands
21
Q

What are the types of epulides

A
  • fibrous epulis
  • pyogenic granuloma (vascular epulis/pregnancy epulis)
  • peripheral giant cell granuloma (giant cell epulis)
22
Q

What is the presentation of fibrous epulis

A

pedunculated/sessile
firm consistency
same colour as adjacent gingiva
surface may be ulcerated and may be covered with yellow fibrous exudate

23
Q

How does a fibrous epulis present histologically

A
  • granulation tissue present
  • inflammatory cell infiltration, mostly plasma cells
  • calcifications/metastatic bone within fibroblastic tissue may be seen especially if there is ulceration of the covering stratified squamous epithelium
24
Q

What is a pyogenic granuloma

A

contains granulation tissue
can occur on any mucosal sites

25
Q

What is the cause of pyogenic granuloma

A

trauma

26
Q

What is a pyogenic granuloma called on the gingiva

A

vascular epulis or pregnancy epulis (if pregnant)

27
Q

What is the presentation of vascular/pregnancy epulis

A

soft, deep reddish-purplish swelling
often extensively ulcerated
haemorrhage may occur spontaneously or to minor trauma

28
Q

What can be seen histologically in vascular/pregnancy epulis

A

granulation tissue
vascular proliferation - vesseles appear dilated and thin walled
ulcerated

29
Q

Why is it important to remove trauma for epulis

A

it will recur otherwise

30
Q

What is the difference between granulation tissue and granulamatous inflammation

A

Granulation tissue = healing tissue. Present in the proliferative phase of healing
Granuloma = aggregation of macrophages in chronic inflammation as they try to remove foreign substances that it is otherwise unable to remove

Phases of healing: haemostasis, inflammatory, proliferative, remodelling

31
Q

Where do peripheral giant cell granuloma occur

A

can occur anywhere but on the gingiva its called giant cell epulis

32
Q

Where is the most common site for giant cell epulis

A

anterior to molars
interdentally (buccal-lingual - indentate px)

33
Q

What is the presentation of giant cell epulis

A
  • pedunculated/sessile swelling
  • varying size
  • typically dark/red
  • commonly ulcerated
  • often interdental
34
Q

How does giant cell epulis appear histologically

A
  • focal collections of multinucleated giant cells
  • large no. of vascular channels
  • extravasated red blood cells and deposits of haemosiderin are present

haemosiderin is caused by breakdown of haemoglobin producing brown stain

35
Q

Why should you always radiograph a giant cell epulis

A
  • it is possible for a central giant cell granuloma to perforate the cortex and present as a peripheral lesion
36
Q

Why can a vascular epulis mature to a fibrous epulis

A

due to granulation tissue
first phase of granulation tissue formation is vascular followed by fibrous

37
Q

Where are fibroepithelial polyps usually seen

A

cheek
lip
tongue

38
Q

How do fibroepithelial polyps usually present

A

painless
pedunculated/sessile
polypoid swelling
ulceration not a feature

39
Q

What are mucoceles

A
  • cysts arising in connection with minor salivary glands
40
Q

What are the two types of mucoceles

A

extravasation cyst
mucous retention
ranula

41
Q

When should you refer oral mucosal diseases

A
  • symptomatic
  • abnormal overlying/surrounding mucosa
  • increase in size
  • rubber consistency
  • trauma from teeth
  • unsightly
42
Q

Why is it important to refer symptomatic lesions

A

pain is a sign of salivary gland malignancy

43
Q

When would you tend not to refer oral mucosal diseases

A

tori
small polyp
mucoceles unless they become fixed in size

44
Q

Signs of iron deficiency

A

mouth ulcers
glossitis
angular cheilitis

45
Q

Signs of B12 deficiency

A

beefy tongue

46
Q

If the MCV shows the cells are microcytic, what type of anaemia may this be

A

fe deficiency
thalassaemia

47
Q

If the MCV shows the cells are macrocytic, what type of anaemia may this be

A

B12/folate deficiency
relics

48
Q

If the MCV shows the cells are normocytic, what type of anaemia may this be

A

bleed
renal
chronic disease

BDS4 Oral Medicine (17 decks)

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